Association between prehypertension status and inflammatory markers related to atherosclerotic disease: The ATTICA Study

Abstract Background We sought to evaluate the association between prehypertension status and inflammatory markers (C-reactive protein, white blood cells, interleukin-6, tumor necrosis factor-α, amyloid-a, homocysteine, and fibrinogen), in a random sample of cardiovascular disease-free adults. Methods The ATTICA study is a cross-sectional population-based survey conducted in the Attica region during 2001 to 2002. Based on a multistage and stratified random sampling, 1514 men and 1528 women (18 to 89 years old) were enrolled. The survey included a detailed interview, blood samples collected after 12 h of fasting, and, among other clinical measurements, status of blood pressure levels. Results The prehypertensive population included 653 men (43%) and 535 women (35%). Compared to normotensives, prehypertensive men and women had 31% higher C-reactive protein (P< .01), 32% higher tumor necrosis factor-α (P< .05), 9% higher amyloid-a (P< .05), 6% higher homocysteine levels (P< .01), and a 10% higher white blood cell counts (P< .05), after correcting for multiple comparisons and adjusting for age, body mass index, blood lipids, glucose, food groups consumed, and other potential confounders. Conclusions Studying a large sample of cardiovascular disease-free adults, we revealed an association between prehypertension and inflammatory markers linked to the atherosclerotic process, independently of other coexisting risk factors or unhealthy lifestyle behaviors. Our findings may be of clinical importance, as they suggest that prehypertension might be a pro-inflammatory condition.